What happens when symptoms change?

I was doing not too bad I thought I had my symptoms under control, taking my long lasting nitro and transdermal nitro, and between 2-3 days which I thought bad days I used the sub nitros, BUT, the last few days I would wake up all hours of the night with really bad back/ chest pain and tightness as if I cant breathe! I would spray and go back to sleep eventually... 2 hrs later the same thing and it went on till yesterday I woke 5 am with the same thing... Lasted all day every 2 hrs spray, with little relief but never totally went away, I went to the ER was there for close to six hrs Enzymes and troponins were normal, but oxygen is a big help reduced the pain, I was offered morphine but I declined, I hate the stuff, but I was relieved NO no heart attack!! Slept better last night but did wake up with same pain and used my transdermal before getting out of bed 0.4 took all my meds and still no changes BP too low 74/44 and I'm too scared to use the spray now untill it goes back up again... Is it possible that I have PA as well ? I don't see my cardio till Sept 12

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12 replies. Join the discussion

forgot to mention SOB as well and sweating,

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Hi, Many of us take Ranexa which is in class by itself. Beg your doctor to let you try it even before your next apt. I was in a fetal position with pain for the whole summer 2 yrs. ago until a NYC doc diagnosed the MVD. I did have to increase the Ranexa and also am on Imdur, Norvasc and Diovan. Have breakthrough pain infrequently which I treat with Nitro sublingual. Have had only 2 trips to the ER in the past 2 yrs. Be well. Patty

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Cashmere, this happens a lot until medications get adjusted to where they need to be. I've found I'll do fine for a while and then start having a lot more pain and have to get meds adjusted. It seems to happen every few months for me or if I get extra stressed. Call your cardiologist and get in to the office ASAP. Make sure you tell them you had an ER visit when you request appointment. The nighttime pain does sound like coronary artery spasm. Hang in there and work closely with your doctor.

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Have you had a sleep study. This sounds kinda like you may have sleep apnea. I hate feeling like there's not enough oxygen. Mine is due to low heart rate.

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Haven't had sleep test but I do wake with severe dry mouth once a week maybe or so... Now I have glass of water beside my bed! How do I go about asking the doc for that without insulting her intelligence, I'm Leary on stepping on toes so to speak... If you know what I mean... I am accused of diagnosing myself... And that comes from saying things like sob feels like asthma dr reply was how do you know it's asthma have you had asthma before? It kind of makes me want to suggest nothing! But I did have nights where I thought I woke up catching my breath though and wondered what was that all about...

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I go to see my GP tomorrow we do not have access as we wish to see the specialist / cardiologist anytime, but I could mention it to her to up my dose of the transdermal as I uped my dose of the Isosorbide dinitrate as she suggested I do does CAScomes after MVD or they go together? Or are they the same? My BP monitor have been detecting irregular heart beat in the mornings only this happened now about 4-6 times in the last week and a half is that of concern? I asked the ER doctor but he didn't give me either or I Am being booked for holster monitor and again it does take time they told me they are very busy.

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Your GP should be able to call your cardiologist to discuss med changes if you are not able to see the cardiologist right away. Here in the US the primary care docs don't want to touch your cardiac meds at all if you have a cardiologist. That's why we in the US always suggest going first to the cardiologist. You don't need to go in with suggestions for med changes. Do mention the irregular heartbeat. If you are wondering about sleep apnea, you can always word it as a question and ask the doc what he/she thinks. Something like, "I've heard sleep apnea is sometimes a problem for people with MVD. Do you think that could be happening for me?"

Coronary artery spasm can happen with or without microvascular disease. Anecdotally, I've met a number of people here who have been diagnosed with both. I have been diagnosed with CAS and my doctors have said I might have MVD. The treatment is essentially the same.

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Yarnkitty thanks for your advice, I just came back from my doctor office and she upped my transdermal dose to six and she is going to get in touch with my cardiologist to see what he'll prescribe, and she said that she will seek other help as well, this time she even was much more understanding then the earlier visits, I have a feeling she is doing her own research as well,

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She wasn't too concerned about my irregular heart beat, do you know if we have Ranexa in Canada by the same name?

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Ranexa works wonders for angina. Try it, bet you will benefit too.

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Somehow I missed this... so sorry it is later in replying.

Ranolazine is the medical name of Ranexa. I have not heard of another brand name yet. It is a hit or miss drug and relatively new. Some find it is wonderful and others not much, if any dent in symptoms. I am wondering if you just have not found your "sweet spot" of the nitro amount as of yet? So good for the doc to up to .6!!!! I am liking this doctor if you think she is digging on her own! FINALLY! I am wishing it were the cardio as well?? Hope so. AND do keep in mind microvessels decide to act up as if in cycles at times even if we are "behaving"... darn Beast is it is! It is just one of the reasons this is difficult to treat. It is like riding a wave....

Sounding like spasms to me. But all of these replies are good suggestions. Some of us have had relief with added O2 due to sleep studies. If we are not breathing well as we sleep, this can really aggravate our condition and many other things as well. Worth a poke!

How have you felt since upped transdermal patch?

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Artista, I have done a little bit better since the 0.6 I have noticed a slight difference, tiny step, I'll take it :) haven't seen my Cardio yet, nor have I had my holter monitor yet, they are busy! I'm thinking next on my agenda is sleep test, O Boy like that is going to go over well!! I'm beginning to understand how temperamental is this beast! one never knows!

All I can say: I don't know what I would have done without all the support and info on this site.
Big Hugs

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